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Introduction:
Angela Burke who was a patient admitted to the psychiatric ward for suspected mental health issues required care. When working with mental health patients, it is necessary to use a patient centered care approach which emphasizes on each individual’s personal preferences and needs (Bromley, 2012). The main goal of this is to empower patients so that they can participate and become active in their care and allowing them to have a sense of control of their life (Bromley, 2012). For this to happen, it is essential for Authorised Mental Health Practitioners (AMHPs) to work together in collaboration using the NMBA’s Nursing Practice Decision Making Framework Tool in order to develop an efficient and effective patient centred care plan using goals to avoid or minimise potential risks in a ward setting. This paper will also discuss the different appropriate delegation, supervision and mentoring strategies which can be used amongst the inter-professional in order to create an effective shared
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By using the NMBA’s Nursing Practice Decision Making Framework, it enables the clinician who are making the referral decide whether or not the person they are referring Angela to are accountable, responsible, have authority and competent and/or require supervision to carry out a particular task (Nursing and Midwifery Board of Australia, 2013). A range of inter-professional team which are considered essential for Angela’s care include GP, psychologists, psychiatrists, registered nurses, and social workers (Department of Health, 2014). These members can be delegated as well as are the delegator different roles and responsibilities as they all provide different aspects of Angela’s care as they have different skills and knowledge (Davies & Fox-Young,
Making a clinical decision is a skill that needs to be acquired, and nurses are accountable for any decision that is made, so they need to understand how they make decisions (Nursing and Midwifery Council (NMC), 2015). A greater understanding of how nurses make decision is essential to follow research and development of decision making skills (Clark et al, 2009) . A first step to a decision making process may entail understanding a framework or model. Baumann and Deber (1986) define decision making as situations in which a choice is made among a number of possible alternatives often involving values given to different outcomes”.
The definition of person centred care is to include an individual receiving treatment in all aspects and decisions of both their healthcare treatment and recovery care plan. The Nursing and Midwifery Council (2008) state that nurses should ‘make the care of the people your first concern, treating them as individuals and respecting their dignity’. In 2012, the Scottish government introduced The 10 Essential Shared Capabilities (10 Escs) It has been created to promote and reflect on progressing policy and legislation to improve person centred care, values and beliefs in Scotland. Person centred care is a driving force not only within mental health nursing but all nursing. Whilst the service user and the nurse build a therapeutic relationship and develop a care plan, which is to the service users owns specific needs and wants. It ensures th...
For the case study one considered the overall working environment of the organisation, with a particular client situation to apply the case study arguments around. This client was experiencing a catastrophic reaction to an event. One applied an integrated person-centred approach which considered meeting their needs by listening to the issue, and working with the person, and their family, as well as care staff, Registered Nurses (RN’s) and the Director of Nursing (DON). In order to find a resolution and meet the client’s needs. As well as, adding to their care plan strategies to assist with future behavioural and psychological symptoms of dementia (BPSD). This particular situation fit perfectly within the two questions of; does the organisation prevent me from providing person-centred care, and do we have formal team meetings to discuss residents’ care.
Through the utilisation of the accompanying text, I aim to discuss and reflect upon one person’s care, to which I have had previous involvement. Using the perspectives set out by Chapelhow et al (2005), I aim to gain a broader outlook on what is expected of me as a Student Nurse. Chapelhow et al (2005) has identified six skills that they feel are required of every Health Care Practitioner. These skills are defined as ‘enablers’ as they are fundamental skills that provide the means for expert professional practice (Chapelhow et al 2005). Although there are six skills outlined, I will only be using two of them to analyse the care I provided. I have chosen to use communication and risk management as my two enablers.
Registered Nurse (Ambulatory Oncology) with a current Licence to practice from the Nursing and Midwifery Board of Australia.
One of the vitals skill required by the Registered Nurse is the skill to assign tasks to subordinates (Saccomanos and Pinto-Zipp 2011). When tasks are delegated to subordinates, the RN remains accountable (Nursing and Midwifery Council 2008). On the other hand, an individual who has been given a task also bears responsibility for the task and is answerable to the RN. Hence, delegation involves “responsibility, accountability and authority” (Sullivan & Decker 2005, p. 144). This essay will examine the role of the registered nurse in relation to delegation. Areas that would be discussed includes definitions of delegation, benefits, types of delegaton, nursing process in relation to delegation, common mistakes of delegation, five rights of delegation and barriers to delegation. At the end, it would give a conclusion and also a statement of my learning.
Clinical decision making involves the gathering of information, awareness, experience, and use of proper assessment tools. The term is often used when describing the critical role of nurses. The process is, therefore, continuous, contextual, and evolving. Authentic practices and experienced people are required to offer guidelines when needed. Effective decision making in clinical environment combines skills such as pattern recognition, excellent communication skills, ability to share, and working as a team, reflection, use of the available evidence and guidelines as well as application of critical thinking. A Clear understanding of this term contributes to consistency, broadening of the scope and improving the skills. However, this paper aims at providing an opinion on clinical decision making and how it is connected to nursing practices.
In contemporary nursing practice, nurses need to integrate scientific knowledge and nursing theories prior to providing optimal health care. Nursing theories guide nurses to treat clients in a supportive and dignified manner through client centred approaches. However, it is challenge for nurses to practice client centred care in daily realities due to heavy workloads. In order to assist nurses to decrease the gap between ideal and real practice, Registered Nurses Association of Ontario (RNAO) develops Best Practice Guideline of Client-centred-care (Neligan, Grinspun, JonasSimpson, McConnell, Peter, Pilkington, et al., 2002). This guideline offers values and beliefs as foundation of client-centred care, and the core processes of client-centred care can facilitate provision of optimal nursing care. These four core processes of client-centred care include identifying concerns, making decisions, caring and service, and evaluating outcomes. According to RNAO (2006), ongoing dialogue with clients and self-reflection are essential for nurses to develop their nursing skills and knowledge on client-centred care. As a nursing student, I reflected on written transcripts of interactions between patients and me, so that I could gain insights into client-centred care for further improvement. Therefore, the purpose of this paper is to discuss importance of the core processes of client-centred care in nursing practice through identifying and critiquing blocks to conversation. Based on the guideline of RNAO (2006), respect, human dignity, clients are experts for their own lives, responsiveness and universal access will be elaborated in each core process of client-centre care as reflecting on three dialogues with patients.
I chose to go into nursing because I had taken a sports medicine class in high school I enjoyed, and I thought I would be guaranteed a job graduating that had something to do with medicine. I can remember being so excited to learn how about illnesses and medications, and all the difference procedures done in the hospital. At the time I thought a nurse’s job was to do what the physicians said, and I expected set guidelines that would tell me what I was and wasn’t allowed to do. I had no idea that I was entering onto a career path involving so much complexity, and that the skills I had dreamed of learning were such a small part of nursing in comparison to the emotional, decision making, and critical thinking skills that a nursing career requires. Ethics in nursing was not something that had ever crossed my mind when I chose to take this path, however now ethics is something that I think about every day I am practicing, whether in clinical or theory courses. Ethical theories often come from the idea that because we are human we have the obligation to care about other’s best interests (Kozier et al., 2010), however in nursing ethical practice is not just a personal choice but a professional responsibility.
The practice of using inter-professional teams in delivering care is not a new concept but current health policy requires professionals work within a multidisciplinary team Department of Health (2001) and entrenched in the Nursing and Midwifery Council (2008) Code. The principle focus of this essay is to discuss the importance of inter-professional collaboration in delivering effective health care and what challenges and constraints exist. The integration of a case study will give an insight into inter-professional collaboration in practice.
This essay will explain what patient centred care is, how nurses use it in practice, the benefits of using it, and the barriers that need to be overcome to be able to use it, and the key principles of patient centred care. It will explain how patient centred care enables nurses to communicate and engage with the patients in a more effective way, and how it helps understand the uniqueness of each patient, which helps professionals avoid ‘warehousing’ patients (treating them all the same). It will also demonstrate how this type of care can help maintain the dignity of patients when nurses carry out tasks such as personal care. The Health Foundation describes patient centred care as being a type of health system where patients take control of their own care.
I was also responsible for implementing of therapies and interventions initiated by other IP members as I was expected to collaborate with my IP team to ensure positive patient outcomes. The proposed management for identified issues, for example, impaired mobility function were developed by me based on the evidence based tools used in hospitals such as Fall Risk Assessment and Management Tool. The decisions with respect to nursing care and my input in IP team care plan were influenced by not only the complex needs of the patient but also the Nursing and Midwifery Board of Australia (NMBA) nursing scope of practice, NMBA’s Code of Ethics and Conduct whilst upholding the four fundamental ethical principles: autonomy, beneficence, non-maleficence and justice. I believe making ethical decisions and collaboration practice is vital to ensure that I deliver the highest quality of care and safety to the patient. I can also guarantee that the positive and desired health outcomes of the patient is obtained as a result. It appears that in the development of IP care plan, the
The nurses do this by following their scope of practice, this involves being with the patient every step of the way and ensuring they are in proper care. While doing such, the nurses consider their own mental state in order to give that proper care. This example meets the standard of professional responsibility and accountability indicator 6(CRNBC,2013) as the nurses were aware of how to maintain fitness to practice by recognizing how to set boundaries and safeguard their emotional
There are many members of the inter-professional team, all of which are contributing to the healthcare of acute and critically ill patients. Every member of the team has had education and obtained a license of practice compatible to their level of knowledge (Prater, Fundamentals of Nursing, 2013). As a practical nurse you need to be mindful of your scope of practice in relation to registered nurses, certified nurses’ assistants and other healthcare professionals. With so many different people involved in the immediate care of a patient, there is always the possibility of a mix up. The purpose of this paper is to help differentiate between the roles of the healthcare staff, which will in turn help develop a knowledge base for prioritizing care;
According to Grundy et al (2016), care planning is not only about clinical decisions, it is a shared responsibility between the person and the professionals. The professionals involved have a responsibility to make sure they are engaging fully with the person throughout the care planning process and to make sure they are meeting the required needs of each person, which will undoubtedly be different every time. Care plans should be meaningful and personalised to the service user and should include their goals, aspirations, and health needs. Mental health nurses have a duty to offer people evidence-based options and to make sure they fully understand these (Anthony and Crawford, 2000). Care plans are put in place to support person and help the